{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:02:06Z","timestamp":1791313326288,"version":"4.3.1"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pancreatic exocrine insufficiency (PEI) results from a reduction in pancreatic secretion of enzymes, leading to malabsorption of nutrients, intestinal symptoms, nutritional deficiencies and related comorbidities. The diagnosis of pancreatic exocrine insufficiency should be based on digestive tests, mainly the coefficient of fat absorption (CFA), based on the quantification of 72\u00a0h fecal fat excretion (FFE). However, this test is rarely performed in clinical practice. Fecal elastase\u20101 (FE\u20101) is a simple and widely used alternative. This meta\u2010analysis evaluates the diagnostic accuracy of fecal elastase\u20101 for the diagnosis of PEI diagnosed by CFA or 72h\u2010FFE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of databases was performed to identify studies evaluating fecal elastase\u20101 and CFA\/FFE for the diagnosis of pancreatic exocrine insufficiency. Inclusion criteria required original studies with data on sensitivity, specificity and other diagnostic metrics. Two independent reviewers performed data extraction and quality assessment using the QUADAS\u20102 tool. Pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratio (DOR) were calculated and heterogeneity was assessed using I\u2010squared tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies with 888 patients were included. Fecal elastase\u20101 at a cut\u2010off of 200\u00a0\u03bcg\/g showed a pooled sensitivity and specificity of 0.94 and 0.69, respectively, with a DOR of 35.27. Lowering the cut\u2010off to 100\u00a0\u03bcg\/g improved specificity to 0.82 but decreased sensitivity to 0.88. Subgroup analyses showed different diagnostic performance in different clinical contexts, with higher sensitivity in cystic fibrosis (0.98) and higher specificity in chronic pancreatitis (0.81). The positive and negative predictive values are limited in situations with low and high probability of pancreatic exocrine insufficiency, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fecal elastase\u20101 is a sensitive and moderately specific diagnostic tool for pancreatic exocrine insufficiency and is suitable for initial screening in high\u2010risk populations. However, its moderate specificity requires careful interpretation in lower risk settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70061","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:39:52Z","timestamp":1750941592000},"page":"1571-1582","source":"Crossref","is-referenced-by-count":31,"title":["Diagnostic Accuracy of Fecal Elastase\u20101 Test for Pancreatic Exocrine Insufficiency: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-2282","authenticated-orcid":false,"given":"Daniel","family":"de la Iglesia","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Puerta de Hierro University Hospital Health Research Institute of Puerta de Hierro\u2010Segovia de Arana  Majadahonda Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2504-351X","authenticated-orcid":false,"given":"Bel\u00e9n","family":"Agudo\u2010Castillo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Puerta de Hierro University Hospital Health Research Institute of Puerta de Hierro\u2010Segovia de Arana  Majadahonda Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8734-5719","authenticated-orcid":false,"given":"Marco","family":"Galego\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Rama\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Enrique","family":"Dom\u00ednguez\u2010Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12674"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2015.07.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.09.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.10.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/mcg.0000000000000917"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14460"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-017-0233-0"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.3149"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12099"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.01.027"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-25"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780121403"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.39.4.580"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpg.0b013e318180af4f"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","unstructured":"P. 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